GI Radiology Lecture Powerpoint

Question 1

Abdominal x ray advantages and disadvantages

Answer 1

+widely available, low cost, portable, no prep

-less sensitive and low specificity compared to CT, not indicated for trauma or solid organ assessment

Question 2

Abodminal contrast fluoroscopy

Answer 2

A “video” contrast study for barium swallow or small bowel follow thru to diagnose disorders of the esophagus or intestine

Question 3

Abdominal ultrasound advantages and disadvantages

Answer 3

+cost effective, adequate for visceral visualization, no radiation
-operator dependent, poor in obesity, interference

Question 4

Abdominal CT scan advantages and disadvantages

Answer 4

+accurate and quick, distinguishes bowel/gas/bone

-radiation, contrast reaction

Question 5

Oral vs IV contrast

Answer 5

Oral such as barium is used for bowel opacification and not nephrotoxic, IV is iodine based for vascular structures or solid abdominal and pelvic regions

Question 6

Nonenhanced CT is indicated with these situations (4), while contrast enhanced is indicated in these (5)

Answer 6

• head trauma
• spine
• diffuse lung disease (not PE)
• suspected kidney stone

-acute appendicitis, cancer staging, diverticulitis, pancreatitis, suspected PE

Question 7

MRI advantages and disadvantages

Answer 7

+superior soft tissue contrast resolution, no ionizing radiation, safer alternative in renal failure, liver specific contrasts
-metallic implants, long procedure time, increased expense and availability

Question 8

Endoscopic retrograde ccholangiopancreatography (ERCP)

Answer 8

Invasive procedure that uses endoscopy to directly visualize bile duct, most effective for choledocholithiasis and used as diagnoistic and treatment of stones, tumors, bile duct strictures, stent placement, risks include pancreatitis, bleeding, perforation

Question 9

Hepatobiliary iminodiacetic acid scan (HIDA)

Answer 9

Nuclear medicine scan where a radiotracer is injected IV for imaging of gallbladder and biliary tree, most useful for acute cholecystitis

Question 10

“Stack of coins” sign

Answer 10

X ray visual where small bowel folds are smoothly and uniformly thickened caused by intramural bleeding

Question 11

“Free air under the diaphragm”

Answer 11

A finding on a chest x ray where there is separation of the diaphragm above the bowel contents indicative of bowel perforation causing peritonitis allowing for bacteria to potentially cause sepsis

Question 12

Bird beak sign

Answer 12

A finding on a barium swallow where the lower esophageal spincer fails to open due to a variety of obstructive reasons

Question 13

Zollinger ellison and what study is used to visualize it?

Answer 13

A tumor secreting gastrin from pancreas into the stomach that can cause hyper acidity in patients that causes erosion of the walls and rugae thickening

Barium contrast

Question 14

Pyloric stenosis and “olive sign”

Answer 14

Common pediatric disease in newborns 3 weeks where they consistently throw up due to occlusion of the pylorus visible on a barium contrast study as “olive sign”

Question 15

Magnetic resonance cholangiopancreatography (MRCP)

Answer 15

Test of choice to examine diseases of liver, gallbladder, bile ducts, pancreas, and pancreatic duct to evaluate tumors, stones, inflammation or infection, is non invasive and has high sensitivity with highly detailed images but should not be used in patients with decreased renal function

Question 16

Sentinal loop

Answer 16

Short segment of adynamic ileus close to intra-abdominal inflammatory process in cases such as pancreatitis or appendacitis visualized on x ray in a patient with abdominal pain

Question 17

Intussusception places a person at significant risk for…

Answer 17

….bowel ischemia and necrosis

Question 18

Sausage sign or target sign

Answer 18

Visualizations on a ultrasound or CT respectively that are indicative of intussusception of the bowel

Question 19

Coffee bean sign

Answer 19

Torsion of the bowel around the mesentary resulting in bowel obstruction (a volvulus) indicated on x ray

Question 20

Fecolith seen on imaging study, when associated with abdominal pain, has a 90% probability of being…

Answer 20

…acute appendicitis

Question 21

Apple core lesion

Answer 21

A visualization on a CT study in the large bowel indicative of a colon cancer presence

Question 22

Cobblestoning and skip lesions and string sign

Answer 22

Visualizations on a contrast imaging study that are indicative of crohns caused by inflammation and swelling of the bowel wall

Question 23

Collar button ulcers and double tracking ulcers

Answer 23

Visualizations on a radiographic study that is indicative of ulcerative colitis seen with indentations of the large intestine

Question 24

Thumbprint sign (GI)

Answer 24

A radiographic sign of the large bowel wall thickening usually caused by mucosal edema from an infective or inflammatory process